226 - General Anesthesia Considerations in a Patient with Possible Pseudocholinesterase Deficiency

Pseudocholinesterase (PChE) is a plasma enzyme that is important for the catalysis of choline ester drugs. PChE deficiency is an inherited or acquired condition resulting in deficient PChE activity. PChE deficiency can alter the metabolism of choline ester drugs such as succinylcholine and ester local anesthetics. It is typically diagnosed after prolonged paralysis and apnea after general anesthesia (GA) or through genetic testing. Preoperative evaluation is the foundation for anesthesia perioperative management plans. This case report involves a 3 year 10 month patient with a family history of PChE deficiency that had yet to undergo genetic testing. Through communication with the patient's primary care physician and the anesthesiologist, the patient safely underwent GA for dental treatment. It is important to get a thorough medical history of both patient and patient’s family when considering GA to avoid preventable complications.